Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 1169569 | TX |
NPI | 1396838488 |
---|---|
Provider Name | Sharon S. Dickmann |
First Address | Austin, TX 78745-5281 |
Second Address | Austin, TX 78745-5281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 18/03/2010 |